SO...10 weeks of training, feeling stronger and stronger in preparation to my first time to Catalunya on Saturday. Last night I thought I'd have a fun session on the new blocs at Reading. I was climbing well and feeling strong. Jumped on another problem which involved a two finger pocket and suddenly "POP", my finger gave way and I fell off. No pain, but as soon as I tried to apply any resistance to my left ring finger I felt pain and had NO power!!!

Off to A&E... As I work at the wall and coach daily I told the guys my livelihood depended on it...luckily two of the Dr.s in A&E (including the head Dr. for the night) were climbers.

Today I went in again to see a hand specialist. He believes I have a full rupture of the A2 pulley, but obviously needs to see MRI to confirm.

I am off on holiday on Sat (now sunbathing), so delayed the MRI to a week Tuesday.

My question to you guys is the following: Having read AS MUCH AS I CAN do on this forum, Dave's blog, Athlon website, Nicros etc...is leaving it the best option????

I read Adam Lincoln had these, but somehow managed to climb after it happened...absolutely cannot do this...too painful! I've been icing/heat (Lewis reaction) and applying a little pressure for massaging...but don't know what to do?!?!

I need to get back climbing asap, but don't want recurring injuries? When I asked the Dr his opinion, he said if it is only one pulley rupture, then probably bes to leave it. Multiple, then op!?

As well as depressed beyond belief, angry and emotional, I am now confused...

Any help would be hugely appreciated!

Thanks,

Robin

I am based in England and have posted this on our UKBouldering site...I've had very good responses, but seeing if there are any further ideas/new treatment information that you guys can add.

I am now back from Catalunya, a torturous, but enjoyable holiday...upping the psyche for a returned visit once I'm back in the game!!!

Very sorry to hear it. I've blown pulleys in both hands. It sucks, but you can recover completely.

My recommendations:

1 - Buy the book One Move Too Many, and follow the conservative suggestions for recovery.

2 - Look through some of the other posts here about pulley injuries. Let me know if you want a few to start with. These should give you a pretty good idea of a little more detail about rehab than what the book, above, will tell you.

3 - After you've recovered enough to start climbing again, use the H-Taping method. Of everything I've tried, it seems to provide the best support.

4 - Try very hard to avoid closed crimps. If you can increase your strength on open-handed crimps, it's amazing how far they'll take you, before you absolutely *must* go with the closed crimps.

I have that book - very good, but when training, these things happen. I opperate at 8a/5.13b and was training fairly intensively, but the hold it went on was not very dramatic...feet didn't slip, felt solid...very surprised! If you could link some of the posts that would be much appreciated. I've had a lookm through and searched for a while - mainly relating to partial ruptures or generic pulley tears etc...not as useful when we are talking about a complete rupture - as it will not and cannot grow back...so rest/ice baths is the answer for initial inflammation, but not much else. I've started to rrehab on soft sponges, but I fear I am getting scar tissue already and my tendon is catching in the hand...

Climbing is still a while off - pull-ups are near on impossible - so sticking to two fingers/right hand work out...quite difficult.

H-taping is a definite once I start - very good method...

Thanks for the response - and if you could link me up - would be great!!

My last pulley injury was a full rupture of one pulley, and, I suspect, a partial rupture of the next one down. No surgery is indicated, as far as I'm aware, unless you have a full rupture of two or more pulleys, or a full rupture of A2. Here's a few links that you may find helpful:

And you'll note from reading the above that it's pretty common for it to happen with no foot slip or anything. My last injury occurred on a relatively easy 5.12 - on a move I had done before. No foot slip. Who knows why it happened. Must've just put a little more force on it that time. Sucks, but that's how it goes.

I can see you are consistently helping all with these related injuries - very kind of you!!!

Sorry to read your diagnosis was so poor and over such a long period! I have stressed my involvement with GB youth members and that it is my daily job, so luckily I saw people who I genuinely believe wanted to get me back asap...hopefully the MRI (do not know if enhanced or normal) will come back with the answers...

Regardless, I will continue with AROM (like you, cannot clench fist), and I have read that cold water treatment is beneficial in early stages...also given a very soft resistance sponge to start using gently I guess...

One question that arises today: So 2 1/2 weeks since injury and suddenly I am starting to see slight swelling (scar?)...? Also, I was initially told not to stretch the finger, but I am feeling it is very tight when opening...scared of the scar closing my hand up (which someone on GB team said happened to them after a few months of rehab)!?

If you have a complete tear, as you say it cannot grow back. You will probably have some permenent effect from this injury.

There is a reason surgeons dont generally repair a single pulley. The surgery has risks, and the disability resulting from a single pulley tear is pretty small, if you take a "big picture" look at things.

Keep in mind, the surgical incision also needs to heal. This healing comes about due to the formation of more scar tissue.

When you are talking about little, tiny structures that move a lot, scar tissue can cause even more disability than the original injury. Statistically, surgeons wont cut a single pulley because the risk is not worth the potential benefit.

When you are doing your AROM, be sure to open your hand fully, as well as try to make a fist. While this is not really stretching, it is full ROM, and should minimize the chance of getting any kind of contracture. But, you may still end up with some permanent damage from this. You have overloaded your anatomy, and caused catastrophic failure to a tiny structure.

I have had many of the same issues on my ring finger. I never heard a pop, but I had intense pain on the A2 pulley.

My tear, probably, was a Grade 1 that occurred while bouldering and moved to a Grade 2 or 3 while climbing later in the week. I had a pain that felt like the good kind like after a day of hard climbing, except it lasted for 2 days. After 2 days, I went climbing on it. I lead a few 11+'s with minor aggravation, but then on an easy 10-, I had a searing pain from a big side pull. It swelled up after a day. Two weeks later after most of the swelling subsided a cyst in my palm developed.

I tried to climb very easy routes or isolating my finger by taping a splint to it. Truthfully, my best fix was not climbing at all for a week. Icing and heating the finger seemed to help but resting it was the best. I have given up on our spring season because the limestone and rhyolite tuff is to fingery.

I have read it takes ~100 days to heal from the injury. My friends with finger issues have claimed longer healing or that they never truly resolved. GO is the only one I have heard to have cysts, but according to my doctor, they are apparently common for my kind of injury.

Ya - I guess that signature is kind of a head-scratcher for folks who don't know me: Gabe O.

In reply to:

I can see you are consistently helping all with these related injuries - very kind of you!!!

Happy to help. When I had my first injury, the process of learning and healing was... shall we say... somewhat difficult. If I can save others from some of the stress I went though, that would be great.

In reply to:

One question that arises today: So 2 1/2 weeks since injury and suddenly I am starting to see slight swelling (scar?)...? Also, I was initially told not to stretch the finger, but I am feeling it is very tight when opening...scared of the scar closing my hand up (which someone on GB team said happened to them after a few months of rehab)!?

Listen to OAHM and your doctor. All I can suggest is that if the swelling ever increases after the first few days rather than going down, you may be putting too much stress on it - ease up on the rehab, and splint it whenever you *must* put stress on that finger.

So got my MRI results. The "hand specialist" wasn't much help - his radiologist reported full a2 rupture. No other notes made. I had been getting pain in my palm, so was worried that there was damage to a1. The hand specialist said he trusted his radiologist, but I wanted to go through the images with him. He went away and came back saying he thought it was only a2, and was pretty sure (not 100%) that a1 was ok... So I went to the images lab and got the disc. I have uploaded a few to flickr and hyperlinked here...anyone able to see if a1 is ok?? http://www.flickr.com/photos/olearyrobin/

since no one mentioned it, I'll suggest losing weight, if you can. After losing 25lbs over a little over a year, it's amazing how much less closed crimps and pockets hurt. I was 176 5 11.5 and am now 151. However, I till minimize climbing on them and put ample space between for recovery, at least 1-2 weeks between difficult crimping or pocket sessions. If I'm in the gym, I never closed crimp or climb pockets, if I'm training, campusing, I only open hand.

Before I made these changes I had 9 finger injuries, since, I've had 0 and I am climbing harder grades then ever. Ofc, it's more a long term solution. Hope that helps.

MRI is just the best imaging we have. The only way to be "100%" sure about your A1 is to actually cut it open and look at it.

Most ethical surgeons would not do that, since there is no evidence of A1 damage. Others would be happy to cut on you, and maybe really F*** it up.

Stop perseverating. Just get on with the rehab, and be patient.

+1

It sure seems like nothing happening in the images you posted. Though usual cautions of internet diagnosing apply, plus the fact that you didn't really pick images in any sort of useful order. It would have been more useful to include every slice of a single view rather than skip cuts...interpreting an MRI takes a lot of experience, and viewing 20 odd images from what I'm assuming is thousands, isn't the way to handle this.

I'll repeat OAH: you got what sounds like a reasonable diagnosis from a trained professional who has first hand information (i.e. a physical exam) and the complete MRI and an official read from a radiologist. If the surgeon doesn't want to cut you this is typically taken as a sign of a good surgeon. I'd be more worried if he immediately wanted a surgical repair.